www.thelancet.com/psychiatry Vol 7 April 2020 e15 in addition to disease knowledge and protective measures, pre-job training was arranged to address identification of and responses to psychological problems in patients with COVID-19, and hospital security staff were available to be sent to help deal with uncooperative patients. Third, the hospital developed detailed rules on the use and management of protective equipment to reduce worry. Fourth, leisure activities and training on how to relax were properly arranged to help staff reduce stress. Finally, psychological counsellors regularly visited the rest area to listen to difficulties or stories encountered by staff at work, and provide support accordingly. More than 100 frontline medical staff can rest in the provided rest place, and most of them report feeling at home in this accomodation. Maintaining staff mental health is essential to better control infectious diseases, although the best approach to this during the epidemic season remains unclear. The learning from these psychological interventions is expected to help the Chinese government and other parts of the world to better respond to future unexpected infectious disease outbreaks.
1. Meltzer H, Gill H, Petticrew M, Hinds K. Office of Population Census and Surveys (OPCS)—Surveys of Psychiatric Morbidity in Great Britain Report 1: The prevalence of psychiatric morbidity amongst adults living in private households. London: HMSO, 1995. 2. Beekman AT, Copeland JR, Prince MJ. Review of community prevalence of depression in later life. Br J Psychiatry 1999; 174: 307–11. 3. Prescription Pricing Authority (PPA) PACT Centre Pages. Drugs used in Mental Health. http://www.ppa.org.uk/news/ pact-112003/pact-112003.htm (4 November 2004, date last accessed). 4. Middleton N, Gunnell D, Whitley E, Dorling D, Frankel S. Secular trends in antidepressant prescribing in the UK, 1975–1998 J Public Health Med 2001; 23: 262–6. 5. National Institute for Clinical Excellence. Management of depression in primary and secondary care. Clinical Guideline 23. National Institute for Clinical Excellence 2004. 6. Percudani M, Barbui C, Fortino I, Petrovich L. Antidepressant drug prescribing among elderly subjects: a population-based study. Int J Geriatr Psychiatry 2005; 20: 113–8. 7. Lawreson RA, Tyrere F, Newson RB, Farmer RDT. The treatment of depression in UK general practice: selective serotonin reuptake inhibitors and tricyclic antidepressants compared. J Affect Disord 2000; 59: 149–57. 8. Wilson KC, Copeland JR, Taylor S, Donoghue J, McCracken CF. Natural history of pharmacotherapy of older depressed community resident. The MRC-ALPHA Study. Br J Psychiatry 1999; 175: 439–43. 9. Living in Britain. A summary of changes over time – Use of health services. Office of National Statistics (ONS). http://www.statistics.gov.uk (16 February 2005, date last accessed). 10. Rosenbaum JF, Zajecka J. Clinical management of antidepressant discontinuation. J Clin Psychiatry 1998; 59: 535–7. 11. Zermansky AG. Who controls repeats? Br J Gen Prac 1996; 46: 643–7.
Abstract Background Sleep is essential for brain homeostasis, in part by supporting glymphatic clearance through sleep-related oscillations. However, the relationship between putative glymphatic metrics and coupled sleep rhythm disruption, and their combined role in Alzheimer’s disease (AD) progression, remains poorly understood. Methods We analyzed data from 75 individuals, 54 with AD and 21 cognitively normal (CN) controls, including sleep electroencephalography (EEG), magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) AD biomarkers, and two-year longitudinal cognitive assessments. Putative glymphatic metrics was evaluated using choroid plexus (CP) volume, perivascular spaces (PVSs), diffusion tensor imaging along the perivascular space (DTI-ALPS) index, and blood oxygen level-dependent signal coupled to CSF signal (BOLD-CSF coupling). Coupled sleep rhythm was assessed via slow oscillation (SO)-theta and SO-spindle couplings. Correlation and mediation analyses explored associations between these MRI-derived indices and coupled sleep oscillations, and least absolute shrinkage and selection operator (LASSO) regression was used to predict AD progression. Results Compared to CN controls, individuals with AD had reduced DTI-ALPS index and BOLD-CSF coupling (p < 0.05), along with disrupted SO-spindle coupling (p = 0.029). Across all participants, lower global BOLD-CSF coupling correlated with misaligned SO-theta burst coupling (r = 0.311, p = 0.018), and reduced DTI-ALPS was associated with misaligned SO-spindle coupling (r = 0.370, p = 0.008). In the AD group, DTI-ALPS remained correlated with SO-spindle misalignment (r = 0.376, p = 0.028). Mediation analysis revealed that SO-spindle misalignment contributed to cognitive decline through its effect on DTI-ALPS. Importantly, combining putative glymphatic and sleep EEG metrics effectively predicted AD progression. Conclusions Our findings suggest that disruptions in surrogates marker of glymphatic clearance and coupled sleep rhythms are jointly associated with AD-related cognitive decline. These metrics offer a promising framework for predicting disease progression and understanding neurodegenerative mechanisms in AD. Graphical Abstract
Neurosciences. Biological psychiatry. Neuropsychiatry, Neurology. Diseases of the nervous system
IntroductionExposure to potentially morally injurious events (PMIEs) has been found to contribute to mental health difficulties (MHD). However, research on PMIE exposure and its consequences among teachers is scant. In this study, we aimed to narrow this gap by examining the associations between teachers’ exposure to PMIEs and measures of depression, anxiety, burnout, and intention to leave the profession. Furthermore, we examined the mediating role of expressions of moral injury (i.e., shame and guilt) in these associations.MethodA sample of 253 Israeli teachers (186 female, 73%) aged 23-66 (Mage = 44, SD = 10.36) completed validated self-report questionnaires assessing the study variables.ResultsThe findings demonstrated that exposure to PMIEs contributed significantly to depression, anxiety, burnout, and intention to leave the profession. Through structural equation model analysis, we found that expressions of moral injury mediated the association between PMIEs and MHD.DiscussionThis study underscores the need to address moral injury among teachers as an essential factor for maintaining their mental health, as well as the overall sustainability of the educational system. Early screening and interventions are needed to identify and treat teachers at risk for MHD stemming from moral injury.
Md. Adil Faizan, V. Murali Krishna, Tialam Gautham
et al.
Background:
Mental illness continues to be a significant public health challenge, with stigma acting as a barrier to seeking care and improving outcomes. Healthcare students, particularly medical and nursing students, play an influential role in shaping future societal attitudes toward mental health. Their attitudes and perceptions toward mental illness can directly impact the care patients receive and influence how mental health issues are addressed within the healthcare system. Stigma among healthcare students can undermine the quality of patient care, discourage individuals from seeking help, and perpetuate harmful stereotypes that affect wider societal views. This study compares the stigma toward mental illness between medical and nursing students from two educational institutions in Khammam and Warangal, located in Telangana. Telangana was chosen as the study location due to its unique cultural and educational context, which may provide valuable insights into regional variations in stigma and perceptions of mental health.
Materials and Methods:
A cross-sectional study was conducted with 827 students from private medical college (Khammam) and government medical college (Warangal). The Mental Illness Clinicians’ Attitudes-2 (MICA-2) scale was used for medical students, while the modified MICA-4 scale was employed for nursing students to measure attitudes toward mental illness. In addition, sociodemographic data, including gender, previous contact with individuals with mental illness, and academic semester, were collected.
Results:
A total of 827 students participated in the study, with 57.4% of medical students and 42.6% of nursing students. Medical students exhibited significantly higher stigma scores (41.07 ± 6.74) compared to nursing students (38.07 ± 7.44, P < 0.001). Male students had higher stigma levels (41.37 ± 7.06) than female students (36.57 ± 7.33, P < 0.001). Students with prior contact with individuals suffering from mental illness showed lower stigma scores (35.42 ± 8.91) compared to those without prior contact (39.35 ± 6.14, P < 0.001). Students from Warangal had lower stigma scores (38.13 ± 7.03) compared to those from Khammam (39.15 ± 6.54, P < 0.05). Post hoc analysis revealed that medical students from private medical college, Khammam (MedKh) had the highest stigma, followed by nursing students from the same institution. Students from government medical college, Warangal (MedWar) exhibited intermediate stigma, with Government nursing college, Warangal (NurWar) showing the lowest stigma levels.
Conclusion:
This study highlights significant differences in stigma levels between students from various institutions and regions, emphasizing the importance of addressing stigma in healthcare education. To reduce stigma, it is crucial to integrate anti-stigma programs into medical and nursing curricula, with a focus on mental health awareness. In addition, increasing clinical exposure to mental health settings and fostering direct interaction with individuals experiencing mental illness can help reduce prejudice and promote more compassionate care. These actionable steps can support the development of a more empathetic and stigma-free healthcare workforce.
Rok Rajher, Mila Marinković, Polona Rus Prelog
et al.
Abstract Schizophrenia is a chronic and severe mental disorder that still relies on time-intensive, clinician-administered assessments. Although several automated approaches have been proposed to support diagnosis, these systems often lack the level of explainability necessary for informed clinical decision-making. In this study, we present a fully automated and explainable pipeline for detecting schizophrenia from audio recordings of verbal fluency tests, collected from 126 Slovene-speaking participants (68 healthy controls, 58 individuals diagnosed with schizophrenia), leveraging recent advancements in automatic speech recognition (ASR) and large language model (LLM) systems. We evaluated three ASR models–Truebar, Whisper, and Soniox–for transcription quality, and selected the best-performing system for further processing. We semantically enriched the transcriptions using the generative capabilities of LLMs and extracted both verbal and non-verbal features grounded in established diagnostic criteria. We assessed the relevance of these features using a Bayesian statistical framework and trained multiple classical machine learning models for automatic classification. Our best-performing model, an Explainable Boosting Machine, achieved a classification accuracy of 0.82 and an AUC of 0.90. We further generated visual explanations for the model’s predictions, establishing the first fully automated and explainable schizophrenia detection framework developed for the Slovene language. Our approach prioritizes explainability through model-transparent outputs, while still achieving performance comparable to existing automated systems for speech-based schizophrenia detection.
Antea D’Andrea, Pierpaolo Croce, Jordan O’Byrne
et al.
BackgroundThe investigation of mindfulness meditation practice, classically divided into focused attention meditation (FAM), and open monitoring meditation (OMM) styles, has seen a long tradition of theoretical, affective, neurophysiological and clinical studies. In particular, the high temporal resolution of magnetoencephalography (MEG) or electroencephalography (EEG) has been exploited to fill the gap between the personal experience of meditation practice and its neural correlates. Mounting evidence, in fact, shows that human brain activity is highly dynamic, transiting between different brain states (microstates). In this study, we aimed at exploring MEG microstates at source-level during FAM, OMM and in the resting state, as well as the complexity and criticality of dynamic transitions between microstates.MethodsTen right-handed Theravada Buddhist monks with a meditative expertise of minimum 2,265 h participated in the experiment. MEG data were acquired during a randomized block design task (6 min FAM, 6 min OMM, with each meditative block preceded and followed by 3 min resting state). Source reconstruction was performed using eLORETA on individual cortical space, and then parcellated according to the Human Connect Project atlas. Microstate analysis was then applied to parcel level signals in order to derive microstate topographies and indices. In addition, from microstate sequences, the Hurst exponent and the Lempel-Ziv complexity (LZC) were computed.ResultsOur results show that the coverage and occurrence of specific microstates are modulated either by being in a meditative state or by performing a specific meditation style. Hurst exponent values in both meditation conditions are reduced with respect to the value observed during rest, LZC shows significant differences between OMM, FAM, and REST, with a progressive increase from REST to FAM to OMM.DiscussionImportantly, we report changes in brain criticality indices during meditation and between meditation styles, in line with a state-like effect of meditation on cognitive performance. In line with previous reports, we suggest that the change in cognitive state experienced in meditation is paralleled by a shift with respect to critical points in brain dynamics.
Elena Martín-González, Manuela Olmedo-Córdoba, Ángeles Prados-Pardo
et al.
IntroductionCompulsive behavior has been proposed as a transdiagnostic trait observed in different neuropsychiatric disorders, such as obsessive-compulsive disorder, autism, and schizophrenia. Research Domain Criteria (RDoC) strategy could help to disentangle the neuropsychological basis of compulsivity for developing new therapeutic and preventive approaches. In preclinical research, the selection of high-drinker (HD) vs. low-drinker (LD) animals by schedule-induced polydipsia (SIP) is considered a putative model of compulsivity, which includes a well-differentiated behavioral pattern.MethodsThe purpose of this research was to assess the cognitive control and the negative valence system domains in a phenotype of compulsive HD rats. After the selection of animals as HD or LD, we assessed behavioral inflexibility by probabilistic spatial reversal learning (PSRL), motor and cognitive impulsivity by variable delay-to-signal (VDS), and risky decision-making by rodent gambling task (rGT).ResultsHD rats performed fewer reversals and showed less probability of pressing the same lever that was previously reinforced on PSRL, more premature responses after the exposure to longer delays on VDS, and more disadvantageous risky choices on rGT. Moreover, HD animals performed more perseverative responses under the punishment period on rGT.DiscussionThese results highlight that HD compulsive phenotype exhibits behavioral inflexibility, insensitivity to positive feedback, waiting impulsivity, risky decision-making, and frustrative non-reward responsiveness. Moreover, these findings demonstrate the importance of mapping different behavioral domains to prevent, treat, and diagnose compulsive spectrum disorders correctly.
Efforts to promote diversity and inclusion often lack a theoretical basis, which can unintentionally exacerbate issues. In this paper, we describe the development and evaluation results of a theoretically grounded workshop aimed at reducing microaggressions and promoting ally engagement among graduate students in science and engineering. In Study 1, using a Delphi method, eight science and engineering faculty members with backgrounds in diversity efforts provided feedback on workshop development. In Study 2, 107 graduate and advanced undergraduate students engaged in the 90-minute interactive workshop. Results indicate that attendees found the workshop valuable, developed new skills for ally engagement, and planned to engage as an ally moving forward (all averages of closed-ended assessments were 4.21 out of 5.00 or higher). Themes that were identified from qualitative responses mapped onto learning objectives, including raised awareness about microaggressions, sufficient practice, and confidence to improve one’s academic climate. Although microaggressions are common in science and engineering spaces, the present findings illustrated that, for many attendees, the information was new, including research on microaggressions and evidence-based ally strategies. This study offers a theoretically grounded intervention that facilitates intentional behavioral changes, which can help students change norms to support the advancement of women and people of color.
Damage to the vestibular sense organs evokes static and dynamic deficits in the eye movements, posture and vegetative functions. After a shorter or longer period of time, the vestibular function is partially or completely restored via a series of processes such as modification in the efficacy of synaptic inputs. As the plasticity of adult central nervous system is associated with the alteration of extracellular matrix, including its condensed form, the perineuronal net, we studied the changes of brevican expression in the perineuronal nets of the superior vestibular nucleus after unilateral labyrinth lesion. Our results demonstrated that the unilateral labyrinth lesion and subsequent compensation are accompanied by the changing of brevican staining pattern in the perineuronal nets of superior vestibular nucleus of the rat. The reduction of brevican in the perineuronal nets of superior vestibular nucleus may contribute to the vestibular plasticity by suspending the non-permissive role of brevican in the restoration of perineuronal net assembly. After a transitory decrease, the brevican expression restored to the control level parallel to the partial restoration of impaired vestibular function. The bilateral changing in the brevican expression supports the involvement of commissural vestibular fibers in the vestibular compensation. All experimental procedures were approved by the ‘University of Debrecen – Committee of Animal Welfare’ (approval No. 6/2017/DEMAB) and the ‘Scientific Ethics Committee of Animal Experimentation’ (approval No. HB/06/ÉLB/2270-10/2017; approved on June 6, 2017).